曲美他嗪联合阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效观察

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.     

倍他乐克对急性心肌梗死心率变异性的影响

1999年 2月～ 2 0 0 1年 6月 ,我们对 34例急性心肌梗死(AMI)患者治疗时加服倍他乐克 ,并与 32例未服用倍他乐克对照比较心率变异性 (HRV)的变化 ,以探讨倍他乐克对 AMI患者 HRV的影响。临床资料 :6 6例 AMI患者均符合 1978年 WHO制定的心肌梗死诊断标准 ,于发病 2 4 h内入院 ;且除外心功能 Killip 级以上、4 8h内出现房颤、 度以上房室传导阻滞、收缩压<90 mm Hg及 (或 )心率 <5 0次 / m in者。全部病例未有应用β受体阻滞剂及胆碱能药物的记录。 6 6例 AMI患者随机分为两组 :1倍他乐克组 :男 19例 ,女 15例 ,平均年龄 (5 5 .4±…     

带膜支架置入治疗胸主动脉夹层

目的探讨带膜支架置入治疗胸主动脉夹层的指征、方法及疗效.方法 5例Stanford B型亚急性期主动脉夹层患者,在局麻、数字减影血管造影术(DSA)监控下,切开股动脉,将带膜支架置入胸主动脉内膜破口处,封闭破口,置入后重复造影.结果患者原发主动脉夹层破口完全封闭,真腔血流恢复正常,术后1月及6月用多普勒超声和CT血管造影(CTA)复查显示无内漏及移位等并发症,假腔血栓形成.结论 Stanford B型主动脉夹层适合带膜支架介入治疗,具有技术可靠,安全性高,术后恢复快等优点,临床应用前景良好.     

曲美他嗪联合阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效观察

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.     

复方丹参滴丸对不稳定型心绞痛患者血浆内皮素和血小板α-膜颗粒蛋白的影响

目的观察复方丹参滴丸对不稳定型心绞痛患者的临床疗效及血浆内皮素（ET）和血小板α-膜颗粒蛋白（GMP-140）水平的影响。方法168例不稳定型心绞痛患者分为常规治疗组（79例）和复方丹参滴丸组（89例）。所有入选患者均接受硝酸酯类、美托洛尔（或钙拮抗剂）及阿司匹林治疗,复方丹参滴丸组在上述治疗基础上加用复方丹参滴丸10粒,每日3次,连用8周。观察统计两组治疗前1周和治疗结束后1周心绞痛发作次数及自拟的疼痛强度及持续时间记分值,检测治疗前后患者血浆ET和GMP-140水平的变化。结果复方丹参滴丸组和常规治疗组比较,治疗后疼痛发作频率、疼痛强度及持续时间记分均有明显减少,而复方丹参滴丸组的降低程度比常规治疗组明显（P〈0．05）。两组可改善不稳定型心绞痛患者心电图ST段的偏移,而复方丹参滴丸组的疗效比常规治疗组显著（P〈0．05）。两组治疗后血浆ET和GMP-140水平均明显减低,而复方丹参滴丸组的疗效比常规治疗组显著（P〈0．01）。结论复方丹参滴丸治疗不稳定型心绞痛患者疗效明显高于常规治疗,可能与改善血管内皮功能、抑制血小板聚集密切相关。     

阿托伐他汀对急性冠脉综合征患者血浆纤维蛋白原的影响

目的：研究阿托伐他汀对急性冠脉综合征（ACS）患者血浆纤维蛋白原（Fib）的影响。方法：急性冠脉综合征患者112例，随机单盲分为阿托伐他汀组56例，常规治疗组56例，另外随机选择40例正常人做对照组。采用血凝仪法测定Fib含量。结果：急性冠脉综合征患者血浆Fib水平明显升高，明显高于正常对照组（P〈0．01）；阿托伐他汀组和常规治疗组两组治疗前Fib水平比较无显著性差异（P〉0．05）。阿托伐他汀组治疗后Fib水平较前明显降低，而常规治疗组治疗后Fib水平无明显变化，两组比较有显著性差异（P〈0．01）。结论：阿托伐他汀可通过降低Fib水平改善急性冠脉综合征患者血液流变学状态，从而改善心肌供血，抑制冠心病的发生发展过程。     

ST段抬高型心肌梗死患者冠状动脉血流灌注分级与围术期临床指标的关系

目的 探讨ST段抬高型心肌梗死（ST-segment elevation myocardial infarction,STEMI）患者冠状动脉血流灌注分级与围术期临床指标的相关性。方法 回顾性纳入2018年1月至2021年6月于聊城市第二人民医院行经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗的STEMI患者共159例，根据术前心肌梗死溶栓试验（thrombolysis in myocardial infarction,TIMI）血流分级分组，其中TIMI 0～1组和2～3级组分别为121例、38例。分析两组患者一般资料、冠状动脉造影指标及光学相干断层扫描技术（optical coherence tomography,OCT）相关指标，采用Logistic回归模型评价STEMI患者PCI治疗前冠状动脉血流灌注分级独立影响因素。结果 两组患者的年龄、左心室射血分数（left ventricular ejection fraction,LVEF）及氨基末端脑钠肽前体（N-terminal pro-brain natriuretic pe...     

吡格列酮对无胰岛素抵抗的高血压病患者左室肥厚及脑钠肽的影响

目的:探讨吡格列酮对无胰岛素抵抗(IR)的高血压病患者左室肥厚(LVH)及脑钠肽(BNP)的影响.方法:入选无IR的高血压病伴LVH患者60例,随机分成吡格列酮组与常规治疗组.常规治疗组给予依那普利治疗,吡格列酮组给予依那普利和吡格列酮治疗6个月.比较两组治疗前后左心室重量指数(LVMI)、血清BNP水平的变化.结果:吡格列酮组与常规治疗组治疗前后比较,LVMI、血清BNP均下降(P＜0.05),两组治疗后比较,吡格列酮组LVMI、血清BNP下降明显(P＜0.05).结论:吡格列酮能逆转高血压病LVH,并降低血清BNP浓度.     

曲美他嗪与厄贝沙坦联用治疗高血压病伴阵发性房颤

目的探讨曲美他嗪联合厄贝沙坦治疗高血压病伴降发性房颤的疗效及对左房内径、C反应蛋白（CRP）的影响。方法入选高血压病伴阵发性房颤患者160例,随机分为单用胺碘酮组（Ⅰ组）、胺碘酮加厄贝沙坦组（Ⅱ组）、胺碘酮加曲美他嗪组（Ⅲ组）、胺碘酮加厄贝沙坦加曲美他嗪组（Ⅳ组）,每组40例,均服药1年。观察4组治疗前后疗效及左房内径、C反应蛋白的变化。结果4组治疗后．有效率Ⅰ组为46．1％,Ⅱ组为65.0％,Ⅲ组为56．4%．Ⅳ组为74．3％,Ⅱ组、Ⅲ组、Ⅳ组与Ⅰ组比较,差异有统计学意义（P〈0．05或P〈0.01）;Ⅱ组与Ⅲ组比较、Ⅳ组与Ⅱ组、Ⅲ组比较．差异均有统计学意义（P〈0．01）。4组治疗前后比较,Ⅱ组、Ⅳ组左房内径减小,Ⅰ组、Ⅲ组左房内径增大,治疗后Ⅱ组、Ⅲ组、Ⅳ组与Ⅰ组比较,差异有统计学意义（P〈0．01）,Ⅱ组、Ⅳ组与Ⅲ组比较、Ⅳ组与Ⅱ组比较,差异均有统计学意义（P〈0.05或P〈0.01）;治疗岳4组血CRP浓度均比治疗前减低。结论曲羡他嗪联合厄贝沙坦能通过抗炎、抑制左房重构作用预防阵发性房颤复发。     

复方丹参滴丸对不稳定型心绞痛患者血浆内皮素和血小板α-膜颗粒蛋白的影响

目的 观察复方丹参滴丸对不稳定型心绞痛患者的临床疗效及血浆内皮素(ET)和血小板α-膜颗粒蛋白(GMP-140)水平的影响.方法 168例不稳定型心绞痛患者分为常规治疗组(79例)和复方丹参滴丸组(89例).所有入选患者均接受硝酸酯类、美托洛尔(或钙拮抗剂)及阿司匹林治疗,复方丹参滴丸组在上述治疗基础上加用复方丹参滴丸10粒,每日3次,连用8周.观察统计两组治疗前1周和治疗结束后1周心绞痛发作次数及自拟的疼痛强度及持续时间记分值,检测治疗前后患者血浆ET和 GMP-140水平的变化.结果 复方丹参滴丸组和常规治疗组比较,治疗后疼痛发作频率、疼痛强度及持续时间记分均有明显减少,而复方丹参滴丸组的降低程度比常规治疗组明显(P<0.05). 两组可改善不稳定型心绞痛患者心电图ST段的偏移,而复方丹参滴丸组的疗效比常规治疗组显著(P<0.05).两组治疗后血浆ET和GMP-140水平均明显减低,而复方丹参滴丸组的疗效比常规治疗组显著(P<0.01).结论 复方丹参滴丸治疗不稳定型心绞痛患者疗效明显高于常规治疗,可能与改善血管内皮功能、抑制血小板聚集密切相关.